Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio.

The most recognized complications after urethral diverticulum repair are urethrovaginal fistula, diverticula recurrence, and de novo urinary incontinence. Our objective was to determine the rate of de novo stress urinary incontinence (SUI) after urethral diverticulum repair.

We conducted a retrospective review of female patients who underwent urethral diverticulum repair without a simultaneous anti-incontinence procedure over 4.5 years. To determine the rate of SUI, we looked at responses to domain 3 of the urogenital distress inventory-short form (UDI-6), and the rate of subsequent procedures for the treatment of SUI.

A total of 50 female patients underwent urethral diverticulum repair. The median age was 44 years (range, 24 to 73) years. Median follow up was 23 months (range, 3 to 67 months). A total of 34 (68%) were white and 16 (32%) were black; 29 (58%) had simple diverticulum, 19 (38%) had horseshoe diverticulum, and 2 (4%) had circumferential diverticulum. Six (12%) had a history of recurrent diverticulum.Of 50 patients, 5 (10%) underwent a subsequent sling for SUI. Thirty-five patients completed the UDI-6. Eighteen (51%) patients reported no SUI, 10 (29%) reported "a little bit," 5 (14%) reported "moderate," and 2 (6%) reported being "greatly" bothered by SUI. Of patients with no preoperative urinary leakage, 5 of 15 (33%) had de novo SUI postoperatively. Of patients with preoperative urinary leakage, 8 of 11 (73%) had postoperative SUI.

De novo rate of SUI after diverticulum repair was 49% by UDI-6, although most often the SUI was mild. Twenty percent of patients reported moderate to severe bothersome SUI symptoms after diverticulum repair. Ten percent had a subsequent anti-incontinence procedure.

Written by
Lee UJ, Goldman H, Moore C, Daneshgari F, Rackley RR, Vasavada SP.

Reference
Urology. 2008 Mar 18. Epub ahead of print.
doi:10.1016/j.urology.2007.11.138

PubMed Abstract
PMID:18355904

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